Abstract
Introduction: Physiological deadspace (VDPHYS) comprises of the anatomical (VDANA) and alveolar (VDALV) compartments. Atelectasis in respiratory distress syndrome (RDS) and heterogeneous cystic parenchymal lung disease in evolving bronchopulmonary dysplasia (BPD) could contribute to changes in VDPHYS.
Aims: To assess the physiological deadspace in infants with varying pulmonary conditions.
Methods: A prospective study of mechanically ventilated infants was undertaken. The modified Bohr-Enghoff equation was used to calculate VDANA and VDALV. Ethical approval was given by the London Research Ethics Committee.
Results: Sixty infants were included. Thirty-one infants with RDS, 15 infants with evolving BPD and 14 infants, ventilated for poor perinatal adaptation with no lung pathology, were controls. The infants had a median (IQR) gestational age of 29.2 (25.2-34.3) weeks and a birthweight of 1.1 (0.7-2.3) kg. Infants were studied at a median of 3 (2-8) days after birth. There were significant differences in VDALV between controls (0.6 (0.3-1.3) mls/kg) and infants with either RDS (2.0 (0.9-3.6) mls/kg; p=0.001) or evolving BPD (2.5 (1.5-3.1) mls/kg; p=0.001). There was no significant difference in VDALV between infants with RDS and evolving BPD (p=0.626), or in the VDANA component between the different groups (p=0.125).
Conclusions: The higher alveolar deadspace in both the acute phase of RDS and that of evolving BPD may reflect underlying pulmonary abnormalities and disease induced changes. Assessment of VDALV should be considered when determining appropriate volume targeting levels for optimal gas exchange in ventilated prematurely born infants.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4794.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020